Eating disorders are characterised by a preoccupation with food, as well as body weight and shape. The most common types of eating disorder are anorexia nervosa, bulimia nervosa and binge eating disorder. It is estimated that over 1.6 million people in the UK have some form of eating disorder, with young women being the most affected demographic.
What are the different types of eating disorders?
Anorexia nervosa involves using food and exercise behaviours – under-eating and over-exercising – to keep body weight low. Symptoms of anorexia include:
- Spending a lot of time worrying about food and/or body weight
- Eating very little
- Avoiding social occasions that involve food
- Having strict eating and exercise routines
- Low mood
- Feeling cold (a result of low bodyweight)
Bulimia nervosa involves similar behaviours to anorexia, but instead of keeping food intake to a minimum, people with bulimia can have periods where they eat large amounts (known as bingeing) and then attempt to ‘get rid’ of the food they have eaten. This can involve:
- Taking laxatives
- Making yourself vomit
- Over-exercising to burn calories
With binge eating disorder, a person will not engage in compensatory behaviours to ‘get rid’ of the food they eat. Instead, they will overeat, specifically:
- Eating in secret, away from others
- Eating mindlessly – this is eating without thinking, on autopilot
Many people with an eating disorder will engage in a variety of these behaviours and experience a range of the symptoms for the different types of eating disorders. This is referred to as EDNOS – an eating disorder not otherwise specified.
A person can be underweight, a normal weight, or overweight and have an eating disorder.
How are eating disorders diagnosed and treated?
Eating disorders can be difficult to diagnose because someone with an eating disorder will often be resistant to tackling their disordered behaviours. This might involve hiding weight loss or weight gain from family and friends with baggy clothes, lying about having eaten and exercising, bingeing or vomiting in secret.
Signs that someone may need help for an eating disorder could be that a person goes to the toilet straight after eating to vomit, that a person cuts their food up into small pieces and becomes generally secretive, anti-social and depressed.
A doctor will ask someone about their eating habits, weight loss or weight gain and their mood to determine whether they may be experiencing an eating disorder.
Treatment can vary based on the type of eating disorder, but most eating disorders will require some sort of psychological intervention or treatment, as an eating disorder is a mental disorder first and foremost.
If someone has lost an unhealthy amount of weight and is therefore at risk of organ failure, among other serious health issues, they may have to be admitted to an inpatient unit, where they can be monitored and given a weight-restorative diet until they are healthy enough to return home and follow an eating plan more independently.
Alongside a dietitian, people with eating disorders will often be referred to a psychologist or psychiatrist who can help them tackle the underlying reasons for their eating disorder. The most common form of psychotherapy for eating disorders is cognitive behavioural therapy, where the person will work on changing their eating disorder behaviours.
There are a few ways to confirm what sort of reasonable adjustments should be made for an employee with an eating disorder:
An employee may not disclose their eating disorders upfront, but if they do, questions regarding the nature of an employee’s eating disorder and what extra support they may need can be broached sensitively. For example:
- Have they required adjustments in the past? For example, being allocated kitchen space so they can prepare food privately instead of having to eat in a communal canteen.
- Even if the employee does not wish to disclose their eating disorder – or they have not even received a precise diagnosis – an employer can focus on making reasonable adjustments, rather than seeking to determine the precise disability their employee has.
What reasonable adjustments are possible for employees with eating disorders?
Employers have a legal duty to make reasonable adjustments for employees with eating disorders if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has an eating disorder. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.
If the employee does not disclose a health issue or disability which may affect their performance up front, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of eating disorders:
- Flexible working hours to accommodate medical appointments and if required, time off work to attend an inpatient unit.
- Flexible dress code if the employee is experiencing heightened sensitivity to cold as a result of their low body weight, for example.
- Adjustments to duties depending on the severity of their symptoms. For example, someone with low body weight may struggle to perform outdoor duties during the winter due to their reduced body temperature.
- Raising awareness so that colleagues understand the employee’s eating disorders and can help ensure the employee feels comfortable at work, for example, if eating and preparing food apart from colleagues.
Eating disorders Signposting
Beat Eating Disorders – charity supporting people with all types of eating disorders and their families by providing information, forums for talking to specially trained volunteers about living with eating disorders and advice about seeking treatment (0808 801 0677).
Anorexia & Bulimia Care – charity helping people with anorexia and bulimia nervosa receive the correct nutritional advice and emotional support to help them in their recovery, as well as campaigning for increased awareness among the general public (03000 11 12 13).
Mind – charity working to empower people living with all types of mental health issues, to destigmatise mental health problems and to improve mental health care at a policy and practical level (0300 123 3393).